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June 1972

Plasmapheresis With Plasma Exchange in Hepatic Coma: II. Fulminant Viral Hepatitis as a Systemic Disease

Author Affiliations

New York

From the Gastrointestinal Section, Department of Medicine, St. Vincent's Hospital and Medical Center, New York.

Arch Intern Med. 1972;129(6):900-907. doi:10.1001/archinte.1972.00320060048004

Nine patients with acute fulminant hepatic necrosis with stage 4 coma have been subjected to plasmapheresis with plasma exchange. Two emerged from coma only to die from pulmonary complications. Despite improving hepatic function and regeneration of hepatocytes, all patients died of extrahepatic complications. Postmortem studies of one patient (case 7), utilizing immunofluorescent tagging techniques, demonstrated Australia antigen (HAA) in all tissues studied, including liver, brain, heart, lung, ovary, spleen and kidney. Fulminant viral hepatitis is a systemic disease with multiple organ involvement. Therapy should be directed not only to the liver but should include measures designed to combat systemic effects of the

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